What is Lymphedema?
In order to understand what it means to be diagnosed with lymphedema, you must understand what the lymphatic system is and does.
The lymphatic system is a large network of lymphatic vessels, nodes, tissues, and organs that are present all throughout the human body.
It functions to maintain fluid levels, rid the body of toxins and waste, and plays an integral role in optimizing the function of our immune system and immune responses.
So, if anyone asks, the lymphatic system is part of your immune system, it produces cells that help us fight disease, and exercising helps to maintain its function.
Lymphedema is exactly what you think it is– a disorder related to the lymphatic system. Eureka!
Lymphedema refers to the swelling of tissues– this can occur in the arms, legs, head, neck, and even the genitals– caused by an accumulation of protein-rich fluid flowing throughout the body, that, in a healthy individual, is usually drained through the bodies lymphatic system. This accumulation of fluid causes chronic inflammation as well as other tissue changes (i.e., hardening, thickening, etc.).
Some individuals are born with lymphedema, while others develop it after cancer, radiation, parasitic infections, or surgery– often involving the removal of lymph nodes.
In short, any problem that disrupts the flow of lymphatic fluid throughout the body, making it difficult for the lymph nodes to do their job, causes lymphedema.
How do I know whether or not I have lymphedema?
Some signs and symptoms of lymphedema include:
- Feelings of heaviness or tightness in one or more limbs
- Swelling of all or part of a limb or multiple limbs
- Hardening or thickening of the skin in the affected limb
- Difficulty with mobility due to limb size
If you notice persistent swelling or thickening of tissue, as well as feelings of heaviness, contact your doctor.
While lymphedema is not curable, there are ways to alleviate pain, swelling, and reduce the risk of infection.
What can physical therapy do for me if I have lymphedema?
For individuals with lymphedema seeking physical therapy treatment, “The gold standard treatment for lymphedema is CDT.” – Brian D. Lawenda, MD.
Complete Decongestive Therapy (CDT) is made up of five components:
- Manual Lymphatic Drainage (MLD)
- Compression bandaging
- Exercise
- Skin care
- Instructions in self-care
Combining the five components of CDT into the treatment of individuals with lymphedema will not only reduce swelling, but also increase strength and range of motion, decrease the risk of infection, and provide patients with the proper education and means to manage their condition, ultimately improving their overall quality of life.
What is Manual Lymphatic Drainage (MLD)?
Manual Lymphatic Drainage, or MLD, is performed by a practitioner who is certified to perform MLD and/or CDT (including myself!)
MLD is a technique used to re-route lymphatic fluid around the blocked area into the healthy lymph nodes and other lymphatic regions of the body.
MLD helps to stimulate healthy lymph nodes and increase lymphangio activity, which in turn, not only promotes relaxation, but also increases reabsorption of the protein-rich lymphatic fluid by healthy lymph nodes.
What is Compression Bandaging?
Compression bandaging for lymphedema directly complements MLD, by reducing filtration of water into the tissues and preventing the re-accumulation of already evacuated fluid. Compression also helps to improve the bodies muscle and joint pumps.
And exercise?
Exercise is the best way to stimulate the lymphatic system and facilitate lymphatic return.
Compression bandaging, when combined with exercise, further promotes the muscle and joint pumps function throughout the body, helps to stimulate the lymphatic system, and facilities lymphatic and venous return.
An exercise program tailored to each individual will be discussed, customized, and created differently, depending on the individuals goals and abilities.
How about meticulous skin and nail care?
For patients with lymphedema, proper skin and nail care is important for maintaining the integumentary system and preventing infection. This will be discussed further with the individual at the first physical therapy session.
And what do the instructions in self-care involve?
While, as certified lymphedema therapists, we are always excited to treat our patients, self-care for patients is just as important as the time and effort we put into our treatment sessions.
Proper self-care will assure that the patient is able to maintain the decrease in limb size and symptoms that they see after CDT.
Self-care instructions include but are not limited to knowledge of their condition, reviewing skin and nail care, infection prevention, choosing the best compression garment, when and how to wear compression garments, home exercise programs, self MLD, follow-up appointments, etc.
Often, the treatment of lymphedema requires a multidisciplinary approach in order for optimal success. This may include psychological or nutritional counseling for some individuals. There are also a handful of support groups, in person and online, for persons with lymphedema.
How often will I be attending physical therapy?
Lymphedema is treated in phases– intensely for the first few weeks, then progressing to the maintenance or self-care phase.
The intensive phase of lymphedema treatment involves patients being treated daily for several weeks, depending on the severity of the condition. This allows for adequate decongestion of the limb or limbs with the use of CDT.
The maintenance, or self-care phase of CDT is something individuals with lymphedema must adhere with for the rest of their lives.
Patient’s will be provided with adequate education and preparation for this phase by their lymphedema therapist, in order to allow them to successfully manage their condition.
In addition, treatment will always be adjusted depending on the patients condition, presentation, and response to CDT.
As a physical therapist, we improve quality of life through hands-on care, patient education, and exercise.
While there is no cure for lymphedema, with the help of a certified lymphedema therapist, this condition can successfully be managed– preventing infection, reducing symptoms, optimizing function, and improving overall quality of life.
If you have any questions, please don’t hesitate to reach out.
